Facility Evaluation Report

Unannounced Post Licensing visit made out to this facility on 07/01/2024 by Licensing Program Analyst (LPA) Charlie Yang who was met by the facility designated Administrator Nicetas "Nancy" Radaza. A brief interview was conducted with the facility designated Administrator at this time.

It was learned that there was (1) resident under the care of hospice at this time.

This facility does have an approved hospice waiver to be able to accept and retain up to (6) hospice residents at any given time.

It was learned that there were (3) residents receiving care from a home health care agency at this time.

It was learned that there was (1) resident diagnosed with dementia at this time.

Administrator certificate was observed to be present and in compliance at this time for facility Applicant/designated Administrator Nicetas Radaza. Additional forms and documents were reviewed to make sure that the initial certification process was completed and a valid certificate was issued in compliance at this time.

Kitchen area was toured. Cabinets and drawers were reviewed.

Food supply was reviewed for adequate 2-day perishable and 7-day nonperishable quantities at this time. A tour of the dining area, living area, and all other areas intended for resident use was conducted.

Medication cabinet, located in a separate dining area cabinet, was reviewed. Policies and procedures involving dispensing, documenting, and overall administration of resident medications was discussed with the facility designated representative at this time. This medication cabinet was observed to be locked and made inaccessible to the residents at this time.

A tour of the resident bedrooms and restrooms was conducted. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time.

Hot water temperatures were taken and measured to make sure that they were within the allowed range of